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FRI0134 (2018)
Is there any difference in ra patients for methotrexate use vs. leflunomide use as a concomitant treatment with biological and targeted synthetic dmards in turkbio registry?
N. Inanc1, G. Ozen1, Y. Yalcinkaya1, E. Dalkilic2, S.S. Koca3, G. Can4, A. Karataş3, Y. Pehlivan2, A. Yazıcı5, A. Cefle5, A. Tufan6, S. Akar7, S. Senel8, B. Oz3, N. Akkoc9, F. Onen4
1Department of Internal Medicine, Division of Rheumatology, Marmara University, School of Medicine, Istanbul
2Department of Internal Medicine, Division of Rheumatology, Uludag University, Bursa
3Department of Internal Medicine, Division of Rheumatology, Fırat University, Elazıg
4Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University, Izmir
5Department of Internal Medicine, Division of Rheumatology, Kocaeli University, Kocaeli
6Department of Internal Medicine, Division of Rheumatology, Gazi University, Ankara
7Department of Internal Medicine, Division of Rheumatology, Katip Çelebi University, Izmir
8Department of Internal Medicine, Division of Rheumatology, Erciyes University, Kayseri
9Private Practice,. , Izmir, Turkey

 

Background: TURKBIO registry is the Turkish version of Danish DANBIO rheumatologic database which has been established in 2011. Demographics and previous or current treatment with conventional (csDMARD) and targeted synthetic (tsDMARD), and biological DMARDs (bDMARDs) were collected.

Objectives: We aimed to investigate the efficacy and safety status of methotrexate (MTX) vs. leflunomide (LEF) use as a concomitant treatment with bDMARDs and tsDMARD in this registry.

Methods: Frequencies of achievement of remission or remission +low disease activity (LDA) at the 6th month of bDMARD or tsDMARD treatment were compared between patients who were on these medications with MTX vs. LEF as a concomitant treatment. Drug survival and switch rates of bDMARDs and tsDMARD treatments either with MTX or LEF were compared. The adverse effects with MTX and LEF concomitant use were evaluated as well.

Results: The study included 725 bDMARD or tsDMARD receiving RA patients from 8 participating centres of the TURKBIO registry. Of these patients, 462 (63.7%) were receiving concomitant MTX and 263 (36.3%) LEF. Demographic findings are given in the table 1. Achievement of remission and remission +LDA at the 6th month of bDMARD or tsDMARD initiation was similar in concomitant MTX vs LEF groups (51.4% vs. 53%, p=0.683). When each bDMARD and tsDMARD was evaluated separately, achievement of remission were again similar in MTX and LEF concomitant users (TNFi: 53% vs. 54%; ABA: 50% vs. 59%; RTX: 53% vs. 61%; TCZ: 42% vs. 35%; p>0.05 for all). For TOFA, although remission +LDA rate was numerically higher in MTX concomitant group than LEF group (42% vs. 21%), the difference was not statistically significant due to the smaller sample size of TOFA (n=33). The results were similar for all DMARD groups when remission was evaluated alone. Drug survival (17±12 vs. 16±11 months, p>0.05) and drug discontinuation (42,2 vs 38, p>0.05) rates of bDMARDs or tsDMARD were also not different in MTX vs. LEF concomitant users. Adverse effects rate (19.5% vs 20.5%, p>0.05) were similar between MTX vs. LEF concomitant users as well.

Abstract FRI0134 – Table 1 Demographic findings of patients.

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Conclusions: Achievement of remission or remission +LDA was not different with the concomitant use of MTX vs. LEF with any bDMARD or tsDMARD treatment in RA patients with a similar safety profile. LEF might be an alternative as a concomitant DMARD in MTX-intolerant RA patients initiating bDMARDs or tsDMARD.

Disclosure of Interest: None declared

DOI: 10.1136/annrheumdis-2018-eular.5662


Citation: Ann Rheum Dis, volume 77, supplement Suppl, year 2018, page A611
Session: Rheumatoid arthritis – biological DMARDs